Reading #6

benefit of ultrasonic cleaning is best demonstrated with

hinged instruments or those with inaccessible areas, hinged retractors, bone cutting instruments

how does an ultrasonic cleaner work

uses sound waves to create tiny bubbles that form and collapse thousands of times each second producing a scrubbing effect known as cavitation on the surface of the items submerged in the liquid

typical processing time of instruments in the ultrasonic machine is

3-6 minutes

temp of ultrasonic machine

maintained at 110F to 130F

product that reduces surface tension

surfactant

organic substances that cause a reaction

enzymes

3 materials for packs wrapping

cotton

linen

paper

4 characteristics of a good wrapping material

selective permeability

resistance

flexibility

memory

what are the advantages of using textile wraps over paper?

they are more resistant to punctures and have a higher flexibility and memory

____ is the best option for textile wrappers

cotton

fabric should be selected by

thread count

disadvantages of textiles

must be laundered after each use

reluctance to discard punctured wraps

what is recommended when securing wrapping material in place

steam indicator tape

what should be written on the indicator tape on the pack

name/date

type of pack that is within

two types of dating for sterilized items

shelf life expiration and event based expiration

includes a predetermined date that identifies how long an item should be considered sterile

shelf life expiration

determined from an environmental perspective , pack is deemed sterile until an "event" occurs

event related expiration

small metal instruments autoclaved and double wrapped linen or plastic/paper combinations can be safely stored for at least ___ weeks

96 weeks (2 yrs)

what is the last step in the cleaning process after presoaking/precleaning, decontamination, and wrapping is _____

sterilization

how is sterilization defined

the use of a process to rid an object of all living microbes

what are the two types of sterilizers

autoclaves (small animal)

gravity air displacement autoclaves and high vacuum sterilizers

proper sterilization depends on what 3 factors

Proper operation of the sterilizer

Proper preparation of the packs

Proper loading of the sterilizer

type of autoclave found in most small animal clinics on the tabletop

gravity air dispenser autoclave

gravity air dispenser autoclave temp and pressure

250-270 F

15 -27 pounds per square inch

type of autoclave found in busy referal/specialty hospitals or teaching hospitals

high vaccuum sterilizers

proper operation of a high vaccuum sterilizer

temp 250-272 F for 4 mins at 32 PSi

order of operation for a high vacuum sterilizer

1. conditioning phase 17 mins

2. sterilization phase for 4 mins

3. high vacuum exhaust for 4 mins

4. drying cycle for 20 mins

total being 45 mins

what are the main differences of high vacuum vs gravity air displacement

causes steam to penetrate the pack more quickly it also pulls steam out of the pack to prevent condensation

____ sterilization is an abbreviated version of a regular sterilization cycle

flash

instruments sterilized by this method are not wrapped and are usually sterilized one or two instruments at a time

flash sterilization

autoclave settings for flash sterilization

272 F for 2-3 mins

toxin that can cause skin and mucous membrane irritation but can be used for sterilization

ethylene oxide (EtO)

what does effective EtO sterilization depend on?

conc of gas

exposure time

temp

relative humidity

optimal relative humidity for eto sterilization is

40%

3 most common states of matter

solid liquid gas

4th state of matter

plasma (lightning)

plasma state of matter is produced through the action of a

strong electric or magnetic field

the plasma system uses ___ ____ to form the reactive components to kill microorganism

hydrogen peroxide

one limitation of gas plasma sterilization is that it cant

penetrate the walls of an instrument with a lumen, and thus the area within the lumen is not sterilized

does it mean the instruments are sterile if the indictor strip turns color?

no, it only means that the conditions were met for sterilization to have occurred

vial of ___ ____ a biological indicator is usually placed in the first load of the day and then placed in an incubator for 24 hours to make sure sterilizer worked properly that time

bacillus stearothermophilus

___ ___ is more of a high level disinfection process than a true sterilization process

cold sterilization

practice of immersing items in a disinfectant solution to reduce the level of contamination

cold sterilization

some instruments cant withstand being repeatedly exposed to high temps so this is a better option

cold sterilization

the scope and light cable on the laparoscopic instruments can be ___ ____or ___ ____

gas sterilized (ethylene oxide) cold sterilization

iatrogenic

produced by treatment or persons doing

how to maximize the effect of the water moving through the suction channel when cleaning an endoscope

1. insertion tube placed in bowl of water

2. suction button pressed 5 secs while aspirating up the water

3. suction button released

___--___ ____ is recommended for endoscopes becuase they cant withstand the sterilization methods

high level disinfection

submerge the endoscope in ____ _____ for ___ minutes

Cidex OPA for 40 minutes

supplies purchased for single time use

disposable supplies, scalpel blades gloves, suture

cleaning equipment and agents for the surgery room should be

cleaned and stored in the surgery room

The Centers for Disease Control and Prevention (CDC) states elimination of microorganisms from the surgery room is best accomplished by

physical removal by scrubbing

How should the cleaning equipment for the surgery room be handled prior to storage at the end of the day?

dissassembled cleaned dried

Which disinfectants are toxic to cats?

phenol based

Which disinfectant may be inactivated by hard water?

quarternary amine based

Presoaking of surgical instruments involves placing the soiled instruments in:

distilled water mixed with a detergent

What product is used in ultrasonic cleaning of instruments to reduce surface tension?

surfactant

What product is used in ultrasonic cleaning of instruments to assist in the breakdown of biological contaminants?

enzyme

Which of these items should not be used in the cleaning of surgical instruments?

wire brush

The scrubbing effect caused by ultrasonic cleaners is called:

cavitation

The last step in instrument cleaning, prior to wrapping a pack is:

lubrication

Selective permeability is the quality of a pack wrapping material that

allows steam or gas to penetrate the wrap for sterilization to occur

What information should the label of a pack include?

name/initials or preparer, sterilization date, type of pack

The process to rid an object of all living microbes is:

sterilization

When performing ethylene oxide sterilization, how long should the sterilized instruments be aired out if an aerator is not used?

24 hours

What compound is used to clean a laparoscope and its fiber optic light cables?

ethylene oxide

Which compound is used for cold sterilization and is viricidal?

glutaraldehyde

What type of disinfectant inhibits the growth of bacteria?

bacteriostat

Which of these is an example of a disposable surgical supply?

paper drape

why are most packs light green blue gray

to avoid strain on eyes if they were white